Tuesday, August 28, 2012

"A new study of six methods of determining a patient’s risk for heart disease has shown a CT scan of calcium build-up in the arteries around the heart might be the most accurate test.
The new study from researchers at Wake Forest Baptist Medical Center in Winston-Salem, North Carolina reviewed the effectiveness of six different heart disease indicators, including coronary calcium buildup (CAC), blood pressure in the arms and legs, carotid artery thickness, blood vessel health and family history of heart disease.
According to lead researcher Joseph Yeboah, any of these indicators could help improve the current standard of heart disease prediction, known as the Framingham Risk Score (FRS).
“We know how to treat patients at low and high risk for heart disease, but for the estimated 28 million Americans who are at intermediate risk, we still are not certain about the best way to proceed,” he explained in a news release.
“If we want to concentrate our attention on the subset of intermediate-risk patients who are at the highest risk for cardiovascular disease, CAC is clearly the best tool we have in our arsenal to identify them.”

I would be very cautious before jumping to order this test for my patients. First of all, the amount of radiation exposure is not insignificant. Second, how frequently do you have to have to test to watch for progression of disease. And, third, in my experience the coronary lesions with the most calcium tend to be the most stable plaques and much less likely to rupture and cause Acute Coronary Syndrome (a heart attack).

I have a new patient that has always struggled with hypertriglyceridemia. When I first saw him, his fasting triglyceries were 315 (recommended is < 150) on 40 mg of Lipitor! We stopped the Lipitor and did an NMR (advanced lipoprotein analysis) and his tryglyceries were 710 and his LDL were all the more dangerous small, dense variety. This patient was not overweight and was fairly active, playing tennis 3-4 days a week. We discussed "Wheat Belly" and the Paleo lifestyle and the expected changes in his lipid profile: decreased Trig, increased HDL, and a change to large, fluffy LDL. Saw the patient back for health coach every two weeks, and after three months repeated his NMR lipid profile. Amazingly, his triglyceries were now 130! His LDL had shifted to the much less dangerous large fluffy pattern and his "good" HDL had increased 15. This is a patient that had been on medication his entire adult life that increased his risk for developing diabetes, liver and muscle inflammation and may increase his risk for dementia! Now he is free of any Rx medication, only taking Krill Oil and Vitamin D3.

It is not easy, but it can be done!

I highly recommend this article over at www.paleolithicmd.com. It details the sometimes struggles that can occur between the Paleo Lifestyle dedicated physician and his role in traditional medicine. Couldn't agree more with the article.

Most people are aware of the benefits of Omega 3 fatty acid supplementation via fish oil. Numerous studies show the improvement in lipid (cholesterol) parameters and some studies suggest a decreased risk for certain cancers and improvement in inflammatory conditions such as Rheumatoid Arthritis. But, it appears that not all fish oils are created equal. More studies are beginning to show that Krill Oil is probably the most beneficial fish oil supplement. Because of the unique phospholipids in Krill (the little crustaceans that whales eat), the human body shows greater absorption of the beneficial Omega 3's than any other fish oil. While studies so far have been small, their results have been very impressive!

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·Fish oil, also called Omega 3 fatty acids, are beneficial in numerous ways, including anti-inflammatory effects and blockage of plaque formation on arterial walls.LDL reductions have been show to be approximately 5%, triglycerides by 15% and an increase in HDL of 5%.

·Krill oil is a particular type of fish oil which the body may be able to absorb better than other forms.Small studies have shown reduction in LDL by 34%, triglycerides by 20% and an increase in HDL of 43.5%.Larger studies are needed, but preliminary results are encouraging."

I have been using Neptune Krill Oil for approximately two years and I love the fact that there is no fishy aftertaste like some fish oils can cause. While any otc fish oil that states it is 100% Krill Oil should be beneficial, I personally use Neptune Krill Oil from Rejuvenation Science.

In January of 2012, I read "Wheat Belly" by William Davis MD. I had been a fan of his website www.trackyourplaque.com for a couple of years and was intrigued by his theories. I started following the diet at the end the month with a starting bodyweight of 202 pounds at 5'10.5" and 12% bodyfat. I am currently maintaining a bodyweight of 180-184 at 9% bodyfat. My exercise levels (resistance training primarily) did not change from prior to the diet to present. Energy levels are up. I feel better in general. This led me to finding the Primal/Paleo community and my wife and I have adopted the lifestyle with wonderful results. I highly recommend Mark Sisson's website www.marksdailyapple.com for frequent updates on the latest news and thoughts on Primal Living. My wife and I have influenced our neighbors to start living paleo as well, he has lost over thirty pounds since beginning in March and she has lost 10! I have been discussing this approach to many of my patients with wonderful results. I have many that have lost 20-50 pounds over the last 3 months while their blood sugar and lipids all show tremendous improvement. With this website, I plan on following the latest research on Paleo/Primal/Low Carb living, lipid research and management, exercise, and travel (and probably a few other things that I find interesting). I hope whoever stumbles on this site, will get some benefit from my experiences and the information shared.